Individual provider Active NPI

Vanessa L. Roman, LMHC, MCAP

  • Mental Health Counselor
  • Clearwater, FL
National Provider Identifier
1518330679
Registry record updated Aug 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH13708 Issued in FL
Practice address
2400 Winding Creek Blvd
#16-204
Clearwater, FL 33761-4326
Phone
(727) 330-4957
NPI assigned
Nov 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH13708 FL Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X MCAP100051 FL

Addresses

Primary practice location

2400 Winding Creek Blvd
#16-204
Clearwater, FL 33761-4326

Mailing address

2400 Winding Creek Blvd
#16-204
Clearwater, FL 33761-4326
Phone (727) 330-4957

Other identifiers 1

IdentifierTypeStateIssuer
016124800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MCAP100051FLMDAddiction (Substance Use Disorder) Counselor
MH13708FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472083200000",
    "number": "1518330679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WINDING CREEK BLVD",
            "address_2": "#16-204",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614326",
            "telephone_number": "727-330-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 WINDING CREEK BLVD",
            "address_2": "#16-204",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614326",
            "telephone_number": "727-330-4957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN",
        "first_name": "VANESSA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LMHC, MCAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2016-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH13708",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "MCAP100051",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016124800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.